Intraoperative Ultrasonography Combined with Indocyanine Green Video-Angiography in Patients with Cerebral Arteriovenous Malformations.

Abstract

During the operation, accurately identifying the boundary of cerebral arteriovenous malformation (AVM) and discriminating between feeding arteries and draining veins is the key to successful surgical treatment of cerebral AVM. We evaluated the application of intraoperative ultrasonography (IOU) combined with intraoperative indocyanine green video-angiography (IOICGA) in the patients with cerebral AVM. The effects of IOU combined with IOICGA on AVM surgery were observed in 12 patients with cerebral AVM. The lesions of cerebral AVM were completely removed in the 12 patients. IOU could clearly visualize the boundary of AVM, so no patients had massive hemorrhage caused by rupture of malformed vessels. IOU also could detect the location of deep vessels and a total of 11 deep vessels were identified in the 12 patients. IOICGA was performed 41 times altogether in the 12 patients, and 31 feeding arteries and 10 draining veins were identified, so there was no massive hemorrhage caused by misjudgment of feeding arteries or draining veins. IOU combined with IOICGA can identify the boundary of AVM, detect deep vessels, and discriminate between feeding arteries and draining veins, reducing operation difficulty, decreasing mortality and disability rate, and increasing the rate of complete excision.